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08. COVER STORY: PRE-, PERI-, AND NEONATAL HEALTH
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Thirty-nine years ago I had my first baby. I also had pre-eclampsia. In those days we called it toxaemia of pregnancy. I had it with my second and third babies too. But it was not until that second baby was pregnant herself that I realised just how dangerous the condition was. I also realised that it had a very strong genetic component.
My mother lost her first child, my elder sister, to pre-eclampsia 63 years ago. Ten years ago my daughter and grand daughter nearly suffered the same fate. Thankfully, they both survived. But, in my ignorance, I had failed to alert my daughter and her doctors to this potentially fatal family trait. I vowed to do all I could to prevent other women making the same mistake.
Very few of us know that at least five women die from pre-eclampsia in the United Kingdom every year. Or that it claims the lives of at least 600 babies a year. Or that tens of thousands of women are badly affected by it. Or that many more are rushed into hospital for emergency caesarean sections and spend days recovering in intensive care. Or that their babies, who are almost always born prematurely, spend weeks in Special Care Baby Units. Or that it leaves many mothers and babies with long term medical problems. In fact, most of us have never heard of it.
What is pre-eclampsia? Obviously it is something that only occurs in pregnancy and it is caused by problems in the development of the placenta. Though these problems are present in the first part of a pregnancy the symptoms only manifest themselves towards the end. These are: raised blood pressure, headaches, protein in the urine and swelling of the body. Most cases are mild but an unfortunate few become rapidly and seriously ill.
The charity Action on Pre-Eclampsia estimates that, in its broadest form, pre-eclampsia affects almost 65,000 women in Britain each year. Yet the majority of these women hear of the condition for the first time as they are lying on the operating table being prepped for an emergency caesarean. Action on Pre-Eclampsia's Help Line receives over 4,000 calls a year from women who have been badly affected by the syndrome. Many are searching for support - even more are searching for information.
In today's information rich age this is nothing short of scandalous. Pre-eclampsia is the most common of the serious complications of pregnancy yet is rarely featured in the extensive maternity press - though there are some laudable exceptions.
Midwives do not mention it much either. Some do not want to frighten their patients. Others say that they do not want to add to the already formidable amount of information women are given at the start of their pregnancies.
General Practitioners are no better. A couple of background questions would have uncovered my daughter's problem. But these were never asked and her university educated MP mother did not realise the implication of the symptoms she herself had suffered during pregnancy.
Women of all ages need to be informed of the signs and symptoms of pre-eclampsia. Then mothers and grandmothers can tell their daughters if they, or any other members of their family, have had the condition. Pregnant women can tell their medical advisors if they notice that anything is wrong instead of just putting them down - as my daughter and I did - to general tiredness and over work.
The early detection of a genetic pre-disposition and the early identification of the symptoms is extremely important in pre-eclampsia because the only cure is delivery of the baby and its placenta. At a time when we are thinking of reducing the number of ante natal visits the average pregnant woman has with her medical advisors I cannot stress the importance of making sure that all pregnant women and health professionals are aware of the signs and symptoms of pre-eclampsia enough. If it is caught early enough pre-eclampsia can be managed. If it is not it can be fatal.
We cannot reduce the incidence of pre-eclampsia but we can prevent it killing women and their babies. My daughter, like me, had pre-eclampsia with her second pregnancy as well. But this time we were prepared. Her symptoms were identified and managed. Her baby went to full term. She and her sister are now lively, occasionally naughty, young girls who give me great joy. But I often think of how nearly we lost them to pre-eclampsia.